Deductible excess health insurance

If you have a health insurance in The Netherlands you will sometimes have to deal with the deductible excess, sometimes referred to as 'own risk' (in Dutch: eigen risico).

In this article you will find out:

• What the deductible excess is and how it works
• How much the deductible (eigen risico) is
• When you are (and aren't) required to pay a deductible

Let's dive right in.

What is an insurance deductible and how does it work?

The deductible excess is the amount you will need to pay by yourself before you receive coverage from your insurance company.

Good to know:

• You will pay a deductible in addition to your premium.
• The eigen risico is only paid when medical costs are incurred
• The deductible excess is applied per calendar year (January 1st to December 31st)
• The deductible figure stacks up during the year and resets with every new year

Example

1. You go to your family doctor (huisarts) for a consultation in your neighbourhood
2. He/she refers you to a internist in the hospital for a simple surgery and (bill: € 340)
3. The internist prescribes medication which you pick up a the pharmacy (bill: € 65)
4. 385 euro of deductible is payed by you. 20 euro is covered by the insurance company
5. A few months later you have to go back to the internist for a check-up (bill: € 190)
6. The full amount (€ 190) is covered by your insurance company, since the excess has already been payed for.

Overview:

In this case 210 euro is covered by the insurance company. The rest is paid by you.

How much is the deductible?

The compulsory deductible is 385 euro per person in 2023 and 2024. This own risk amount is decided by the government.

Only people that are 18 years or older who have a Dutch health insurance pay a deductible. Children are exempt.

When do you need a pay a deductible?

You will only be required to pay the deductible when costs are incurred that are part of your basic health insurance.

This is the case for:

• Hospital treatments, checkups and visits with a specialist
• Blood tests and other laboratory tests (on prescription)
• Medication, prescribed by a doctor
• Emergency medical care and transportation
• Mental healthcare with a psychologist, psychiatrist or with a GGZ-clinic

When don't you need to pay a deductible?

You won't need to pay eigen risico (deductible excess) for certain medical costs.

For example:

• Consultations and treatments performed by your family doctor (GP) or within the GP-practice
• Emergency treatments at the GP out-of-hours service (huisartsenpost)
• District nursing care (wijkverpleging)
• Obstetric care and maternity care
• Certain medical aids
• Healthcare that is covered in your supplemental insurance

Voluntary deductible

With most Dutch health insurance policies it is possible to increase your deductible voluntarily with steps of 100 euro to a maximum of 885 euro per year.

Doing this will lower your monthly premium, whilst increasing your total 'eigen risico'.

Check our tool to see what increasing your deductible means for you.

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